Abstract

The policy of deinstitutionalisation i.e. the closure of large psychiatric hospitals and a move towards community-based mental health services has been a feature of services developments in liberal democracies. This policy was the result of a series of criticism of the abusive nature of institutional psychiatry. Though the policy has its roots in a body of essentially, progressive ideas, the policy was pursued at a time when neo-liberal governments were in power – this is particularly the case in the USA and UK. The anti-statist, individualist themes of the critics of chimed with several tenets of neo-liberal ideas. The results of deinstitutionalization have been largely very poor. Community mental health services were largely underfunded, poorly organized and unable to cope with the demands placed upon them. In addition, other social problems such as mass unemployment, the destructive impact of increased substance misuse combined with the reduction in other aspects of welfare state provision meant that the institution was replaced, for many, by a bleak existence for the margins of urban society. More people with mental health problems were drawn into the Criminal Justice system.